Tuesday, August 11, 2015

School work, college applications, extracurricular activities, and parental expectations all contribute to teenagers' stress in selective high schools

Youth, schools, and experts identified substance use as a common strategy for coping with stress"School, homework, extracurricular activities, sleep, repeat--that's what it can be for some of these students," says Noelle Leonard, PhD, a senior research scientist at the New York University College of Nursing (NYUCN).

According to Leonard academic, athletic, social, and personal challenges have been regarded as domains of "good stress" for high school aged youth. However, there is growing awareness that many subgroups of youth experience high levels of chronic stress, to the extent that it impedes their abilities to succeed academically, compromises their mental health functioning, and fosters risk behavior. Furthermore, this chronic stress appears to persist into the college years, and Leonard warns it may contribute to academic disengagement and mental health problems among emerging adults.

"We are concerned that students in these selective, high pressure high schools can get burned out even before they reach college," noted Leonard. "The Charles Engelhard Foundation is interested in the issue of college engagement, and funded us to explore whether the roots of disengagement reach back as far as high school. We found that indeed they do."

In a four-phase quantitative and qualitative study published in Frontiers in Psychology in July 2015, a team of NYUCN researchers led by Leonard assessed the coping skills, academic engagement, family involvement and expectations, mental health symptoms, and substance use among juniors enrolled in two highly selective private secondary schools in the Northeast: one an urban day school; the other a boarding school.

"While there is no doubt students in selective public high schools also experience high rates of chronic stress, we decided to study the private school setting, which has been under-studied compared to public institutions," said Marya Gwadz, PhD, the study's Principal Investigator.

Among the differences, families pay substantial tuition rates for a private education and most students are affluent, and "such factors result in a unique set of pressures, expectations, norms, and resources," noted Leonard. The study focuses on students in the eleventh grade. Chronic stress tends to be particularly high for this cohort, as it is generally the point at which students consolidate their portfolios in preparation for college applications.

"We sought to describe the experiences of the students, but also uncover the larger cultural and societal factors that drive the problem of chronic stress, since schools, families, and youth don't operate in a vacuum," said Amanda Ritchie, MAA, a study collaborator. "We know schools and families are embedded in society and are responding to its changing requirements and demands, with respect to the competitiveness of the college admissions process, the kinds of skills needed to succeed in the workforce, and even uncertainties in the global economy."

In the first phase of the study, researchers conducted semi-structured qualitative interviews with nineteen private school teachers, counselors, and administrators to elicit their perspectives on student stress and coping. These responses were in turn used to inform the second phase of the study, a quantitative anonymous internet-based survey, administered to a total of 128 juniors between the two private schools.

About half (48%) of those surveyed reported completing at least three hours of homework a night, with girls 40 percent more likely to report three or more hours of homework a night than boys. Participants demonstrated a relatively strong academic performance, with girls reporting an average GPA of 3.57, higher than boys' average of 3.34. Students showed high levels of motivation for academic achievement, with an average valuation of 2.35 on a scale of 0 (least) to 3 (most). On average, girls were found to be more motivated in this regard than boys (2.48 vs. 2.22). Students reported high rates of feelings of "closeness" to their parents, with an average valuation of 3.15 on a 0-4 scale.

Nearly half (49%) of all students reported feeling a great deal of stress on a daily basis and 31 percent reported feeling somewhat stressed. Females reported significantly higher levels of stress than males (60% vs. 41%). Grades, homework, and preparing for college were the greatest sources of stress for both genders. A substantial minority, 26 percent of participants, reported symptoms of depression at a clinically significant level.

In the third phase of the study, the NYUCN researchers conducted qualitative (semi-structured, open-ended) interviews with eighteen of the students surveyed to provide an interpretation of the results from the students' perspective.

For the fourth and final phase of the research, a panel of eight private school experts was convened-- that included clinical social workers, psychologists, a private school guidance counselor, a teacher with both private and public school experience, a parent of two recent private school graduates, and a student who recently graduated from a private school. The Expert Panel members were presented with the results from the study's three previous phases in individual meetings and the responses from these interviews were used to further interpret and expand upon the data from prior phases.

"I think that parental pressure (on schools and students) is real," said a teacher with over twenty years of experience in the private school sector interviewed in the study's fourth stage. "Parents are coming in and thinking, I'm (spending a lot of money) and I need to get something, a very tangible something. A great education is not a tangible something; a diploma from Harvard, Princeton or Yale ...that's tangible."

Yet it has never been more difficult to enter one of these top-tier institutions, which may accept only 5 or 6 percent of their applicants, although in general a strong student will be able to gain access to any number of good colleges or universities. These highly selective schools and parents are responding to this competitive climate. Private schools have reacted by providing more difficult classes (which may require longer hours of challenging homework), college-level classes, and requiring extracurricular activities, as well as other opportunities for students to stand out, such as entrepreneurial or community service opportunities. Parents, in turn, may demand their children take Advanced Placement courses, even in cases where they are told their child is not a good fit for the course and may not be able to handle the work. Thus schools, parents, and students may feel caught in a cycle of escalating demands and expectations, largely out of their control and driven by greater societal factors.

Importantly, in a theme echoed by schools and experts, students noted that these demands did not always feel appropriate to their developmental levels. Instead, they felt they were asked to work as hard as adults, or even harder, with little time left for relaxation or creativity.

When exploring how students managed the various sources of stress described in the study, researchers found they used a variety of coping strategies ranging from healthy, problem-focused coping, to less adaptive, emotion focused, internal and external avoidance coping strategies. Active or problem-solving strategies for coping with stress included listening to or playing music, playing video/computer games, meditating, or getting away from school. "Three main themes emerged as the most dominant adaptive coping strategies, notably, sports and exercise, preventive activities such as good planning skills, and maintaining a balanced perspective on school and grades," said Leonard.

"On the opposite end of the spectrum, our interviews yielded few descriptions of less adaptive strategies, in contrast to the many adaptive strategies articulated by students, with two exceptions, emotional exhaustion and substance use," said Michelle Grethel, Ph.D., an expert and independent consultant. Students described emotional exhaustion as a feeling of lethargy or immobilization in response to feeling overwhelmed and stressed. "I just don't do anything", "I won't do any of it" or " I lose the ability to function" were some of the ways students described this sense of paralysis. One student recounts: "You get tired. You don't really want to be around people. You just get in this kind of... funk where, like, you just kind of want to be alone in your room and just sleep. Or just like not dealing with anything..."

"Substance use for stress relief was a predominant theme in our interviews with students, over two-thirds of whom described substance use as both endemic to their social experience and as a method for managing stress," says Dr. Charles Cleland, a study investigator. Alcohol and marijuana were described as the primary substances students used for relaxation. As a male student noted: "most of the things that people do, here, when they're stressed is they go get drunk or they get high." However, for the most part students reported that substance use, while very common, did not usually rise to the level of problem or hazardous use.

Substance use for this purpose was not gender specific. One female student recounts, "Marijuana probably was a big anti-stress thing for me last year...just being relaxed for like an hour or two." In fact, the quantitative data indicates no gender differences for general substance use. Over the thirty-day period preceding the survey, 38 percent of students reported getting drunk and 34 percent of students reported getting high on an illegal substance, rates one to two times greater than reported in national normative samples.

"While students didn't discuss prescription drug use, members of the expert panel indicated its widespread use among students for whom it was prescribed as well as those for whom it was not prescribed," said Gwadz. One member of the panel, who counsels students noted "Using Ritalin (a stimulant commonly prescribed for ADHD) is seen only as a benefit and [the students are] incredulous that any faculty or counselor would challenge that taking Ritalin to get an edge in your academic performance, that there could be anything wrong with that ... that's what you have to do in this world."

Stress commonly leads to mental health problems such as depression and anxiety. Results of the study also indicated that parents, more so than their students, experienced a stigma associated with receiving mental health services. Members of the expert panel noted that parents will go to great lengths to avoid taking their children to an outside physician or counselor, as they believe their child will be labeled and such treatment will inhibit their child from getting into the college of their choice.

The researchers note that private schools take a multi-faceted approach to reducing the level of perceived stress and improving adaptive coping among students. High-performing schools mindful of the need to manage chronic stress among students have implemented strategies such as changing school schedules, staggering exams and assignments among different classes, and providing stress reduction opportunities such as yoga and meditation.

"Schools have an opportunity to engage and train families on ways to increase their capacities to serve as resources for their children; to educate families on the deleterious effects of chronic stress and the role of substances in coping with stress; and engage families and students in a dialogue about expectations for achievement and a wider definition of success, all of which may allow students to fully participate in the richness of the private school environment," said Leonard

Both Leonard and Gwadz note a number of promising avenues for future study. Given the exploratory nature of this study, they were unable to interview parents, who play a vital role in how students view and manage stress. While many students, teachers, and expert panel members in the current study discussed the role of parents in some detail, future research should explore parents' hopes and expectations for their children as well as how parents communicate these expectations. The researchers also hope to expand the study to include a more nationally representative sampling of private schools.